Infection

, 37:270

Italian Consensus Statement on Management of HIV-Infected Individuals with Advanced Disease Naïve to Antiretroviral Therapy

  • A. Antinori
  • A. Ammassari
  • C. Torti
  • P. Marconi
  • M. Andreoni
  • G. Angarano
  • S. Bonora
  • A. Castagna
  • R. Cauda
  • M. Clerici
  • A. d’Arminio Monforte
  • A. De Luca
  • G. Di Perri
  • M. Galli
  • E. Girardi
  • A. Gori
  • A. Lazzarin
  • S. Lo Caputo
  • F. Mazzotta
  • F. Montella
  • C. Mussini
  • C. F Perno
  • M. Puoti
  • G. Rizzardini
  • S. Rusconi
  • V. Vullo
  • G. Carosi
Consensus Report

DOI: 10.1007/s15010-008-8134-8

Cite this article as:
Antinori, A., Ammassari, A., Torti, C. et al. Infection (2009) 37: 270. doi:10.1007/s15010-008-8134-8

Abstract

Background:

Individuals with advanced HIV infection naïve to antiretroviral therapy represent a special population of patients frequently encountered in clinical practice. They are at high risk of disease progression and death, and their viroimmunologic response following the initiation of highly active antiretroviral therapy may be more incomplete or slower than that of other patients. Infection management in such patients can also be complicated by underlying conditions, comorbidities, and the need for concomitant medications.

Aim:

To provide practical guidelines to those clinicians providing care to HIV-infected patients in terms of diagnostic assessment, monitoring, and treatment.

Conclusions:

The principals of antiretroviral treatment in asymptomatic naïve patients with advanced HIV infection are the same as those applicable to the general population with asymptomatic HIV infection. Naïve patients with advanced HIV infection and a history of AIDS-defining illnesses urgently need antiretroviral treatment, with the choice of antiretroviral regimen and timetable based on such factors as concomitant treatment and prophylaxis, drug interactions, and potential concomitant drug toxicity. Finally, an adequate counseling program – both before and after HIV-testing – that includes aspects other than treatment adherence monitoring is a crucial step in disease management.

Copyright information

© Springer 2009

Authors and Affiliations

  • A. Antinori
    • 1
  • A. Ammassari
    • 1
  • C. Torti
    • 2
  • P. Marconi
    • 1
  • M. Andreoni
    • 3
  • G. Angarano
    • 4
  • S. Bonora
    • 5
  • A. Castagna
    • 6
  • R. Cauda
    • 7
  • M. Clerici
    • 8
  • A. d’Arminio Monforte
    • 9
  • A. De Luca
    • 7
  • G. Di Perri
    • 5
  • M. Galli
    • 10
  • E. Girardi
    • 1
  • A. Gori
    • 11
  • A. Lazzarin
    • 6
  • S. Lo Caputo
    • 12
  • F. Mazzotta
    • 12
  • F. Montella
    • 13
  • C. Mussini
    • 14
  • C. F Perno
    • 3
  • M. Puoti
    • 2
  • G. Rizzardini
    • 15
  • S. Rusconi
    • 10
  • V. Vullo
    • 16
  • G. Carosi
    • 2
  1. 1.Istituto Nazionale Malattie Infettive “Lazzaro Spallanzani” IRCCSRomeItaly
  2. 2.Clinica Malattie Infettive e TropicaliUniversità degli StudiBresciaItaly
  3. 3.Università di Roma “Tor Vergata”RomeItaly
  4. 4.Università degli StudiFoggiaItaly
  5. 5.Ospedale Amedeo di SavoiaUniversità degli StudiTurinItaly
  6. 6.Università “Vita e Salute”San RaffaeleMilanItaly
  7. 7.Università Cattolica del Sacro CuoroRomeItaly
  8. 8.Università degli StudiMilanItaly
  9. 9.A.O. San PaoloUniversità degli StudiMilanItaly
  10. 10.Ospedale L. SaccoUniversità degli StudiMilanItaly
  11. 11.Ospedale S. GerardoUniversità Milano-BicoccaMonzaItaly
  12. 12.Ospedale S.M. AnnunziataFlorenceItaly
  13. 13.Ospedale S. Giovanni AddolorataRomeItaly
  14. 14.Policlinico UniversitarioUniversità degli StudiModenaItaly
  15. 15.Ospedale Luigi SaccoMilanItaly
  16. 16.Università “La Sapienza”RomeItaly